Plastic surgery; its principles and practice . hening or reconstruc-tion of the tendons. will often occur when other types are used. I have had good successwith this method in the relief of contractures on the dorsum and on thepalm of the hand and fingers, and several years ago reported a numberof cases treated bv this method. ^ Fig. 774.—Contracture of the hand following a burn. Duration twenty years.—i and2. Note the limit of extension. The flexion of the little and ring fingers is especially markedand atrophy has occurred. 3. After relief of the contracture a pedunculated flap from theabdom
Plastic surgery; its principles and practice . hening or reconstruc-tion of the tendons. will often occur when other types are used. I have had good successwith this method in the relief of contractures on the dorsum and on thepalm of the hand and fingers, and several years ago reported a numberof cases treated bv this method. ^ Fig. 774.—Contracture of the hand following a burn. Duration twenty years.—i and2. Note the limit of extension. The flexion of the little and ring fingers is especially markedand atrophy has occurred. 3. After relief of the contracture a pedunculated flap from theabdominal wall with pedicle above, was implanted. Photograph, (from above), taken twoweeks later and just before the pedicle was cut. The use of the pedunculated flap from the thoracic or abdominalwall (Berger, Fontan, ]SIurphy and others), or from the back, buttock. Davis. J. S., Surg., Gyne. &. Obst., July, 1917, i. » 6^8 PLASTIC SURGERY or thigh, may be used to cover a defect on the dorsum or palm of thehand accordmg; to its I 234 Pig. 775.—Contracture of the hand, continued.—i. The position and width of thepedicle can be seen. Photograph taken just before the pedicle was cut. 2 and 3. Takentwo weeks after cutting the pedicle. Note the very thick pad of fat and the excessiveamount of skin. 4. Taken eight months later. Note the shrinkage in the flap and alsothe amount of extension possible. This flap is to be left in place some time longer and passive motion continued on the fingers, in order that the joint surfaces maygraduallj adjust themselves, as there has been considerable distortion during the longcontinued flexion. Later a portion of the fat will be removed from the flap, and excessskin will be utilized on the flexor surface of the proximal phalanges of the middle, ringand little fingers. The gradual readjustment of joint surfaces, and the stretching of theligaments in these cases is most important if normal function is to be obtained.
Size: 2714px × 921px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
